Fine Motor Activities to Improve Open Thumb Web Space

open thumb web space activities

An open thumb web space ensures a functional grasp on the pencil and is an important fine motor skill. When the thumb is squashed against the pencil and the index finger, it is difficult to control the pencil with small motor movement changes. These activities are designed to promote an open thumb web space. Why not try using them before a handwriting task to warm up the hands?

This paper clip activity prompts opposition of the thumb with an open thumb web space. Games with paper clips are a great way to target an open thumb web space.

open thumb web space activities

What is Hand Web Space?

Let’s start by covering thenar web space and the definition of hand web space. The thumb web space is that space between your thumb and pointer finger that makes an “O” when you make the “OK” sign. It’s the first web space, which opens in a spread open palm. This area is also known as the thenar space. 

The web space is that area between the thumb and the index finger.

In order to grasp small items with your thumb and index finger, you need to oppose the tip of your thumb to the tip of your pointer finger. Not only do the tips of the fingers need to touch, but the thumb must rotate at the joint closest to your hand. This opposition is needed to manipulate and grasp small items like shoe laces, buttons, and zippers.

In the hand, there are several anatomical features that impact web space:

  • Thenar eminence– (The bulk of the muscles at the base of the thumb, in the palmar area)
  • Thenar muscles- the abductor pollicis brevis, the flexor pollicis brevis, and the opponens pollicis
  • Carpal bones
  • Metacarpal bones
  • Phalangeal bones
  •  Lumbricals- The main role of the lumbrical muscles is to straighten the fingers to straighten and help bend the MCP joints.
  • Intrinsic Muscles- Also known as the thenar muscles. In the role of the thumbweb space, the intrinsic muscles include: adductor pollicis, flexor pollicis brevis, abductor pollicis brevis, opponens pollicis. These are muscles that originate and end within the hand.
  • Median nerve– the nerve that innervates the thenar muscles, with the exception of the deep head of flexor pollicis brevis and adductor pollicis muscle, which receive their innervation via the ulnar nerve. 
  • Long Flexor Tendons- Tendons that originate outside of the hand, in the forearm of the upper extremity. These muscles bend the wrist forward toward the palm.
  • Extrinsic Muscles- Muscles that originate in the forearm of the upper extremity. Extrinsic muscles include the flexors and the extensors. 
  • Long Flexor Muscles- Flexor Pollicis Longus and Abductor Pollicis Longus. 
  • Long Extensor Muscles- The extrinsic extensors make up the border of the anatomical snuff box: Extensor pollicis longus, Extensor pollicis brevis, and Abductor pollicis longus 

Closed Web Space in the Hand

Closed web space occurs when the thumb is squashed up against the side of the index finger during functional tasks. 

When kids write or color with that web space area squashed shut, it’s a sign of problems. There may be limited dexterity and precision in fine motor tasks when a closed web space is present. 

Then, as a result, there might be compensating for thumb instability, underdeveloped hand arches, and/or poor strength. Each of these problem areas will lead to difficulties with handwriting, dexterity, manipulation of small items like beads, and pencil grasp.

Writing with a closed web space is inefficient and will cause poor and slow handwriting, especially as kids grow and are expected to write at faster speeds. A closed web space while attempting to manage fasteners such as buttons and zippers will lead to fumbling and difficulty.

Web hand space includes two components:

  • Opposition with rotation of the thumb at the CMC joint 
  • Flexion of the distal joints of the thumb (MCP joint and IP joint)

Opposition with Rotation- Related to hand web space is opposition of the tip of the thumb to the tip of the pointer finger. This blog post covers more on opposition with a fine motor paper clip activity

When opposing objects with the thumb and pointer finger, the thumb’s thenar muscles work to oppose with a nice, rounded web opening during functional tasks.  This is needed for advancing and positioning a pencil when writing, precision tasks such as threading a needle. stringing beads, closing a plastic sandwich bag, managing a button with ease, and pulling a zipper.  

With a closed thumb web space and lateral pinch of the thumb versus true opposition, a child will fumble.

 Flexion of Thumb Joints- Also related to thenar web space, or open thumb web space is the flexion of the joints of the thumb. Flexion, or a bent position, allows the thumb to bend toward the palm at the joints in the thumb. 

  1. The CMC joint-CMC joint refers to carpo-metacarpal joint. Also known as the basal joint, or the saddle joint. This joint is located between the trapezius of the carpal joints in the wrist and the metacarpal in the first digit. There are three movements completed by the CMC joint:
    • Flexion- When the CMC joint moves in isolation, the thumb is able to flex, or bend, across the palmar area to touch the base of the pinkie finger, or the small finger of the hand. 
    • Rotation- This joint also enables rotation to oppose the fingertips.
    • Abduction/Adduction- Abduction spreads the thumb away from the second finger and creates a wide web space. Adduction brings the thumb back to the second finger to close the thumbweb space.
  2. The MCP Joint- The MCM joint is the metacarpophalangeal joint. This joint is located between the metacarpal bone and the proximal phalangeal bone in the thumb. When the MCP joint bends in isolation, the joint at the base of the web space across the palm to touch the base of the pinkie finger (5th digit, or small finger). 
  3. The IP Joint- The IP joint is the interphalangeal joint. This joint is located between the proximal pharynx and the distal pharynx of the thumb. When the IP joint works in isolation, only the tip of the thumb bends.

This blog post on a thumb wrap exercise covers more on thumb flexion and the flexion of the individual joints that impact functional grasp on a pencil during handwriting.

web space hand functions

An open thumb webspace is necessary for tasks requiring in-hand manipulation such as moving coins from the palm to the fingertips. If the thumb is squashed up against the index finger, it can not be helpful in manipulating items.

An essential part of a functional open thumb webspace is a flexed thumb IP joint. Read more about this simple tip for a functional pencil grasp that encourages a flexed IP joint.

RELATED READ: Here are activities and tools to address pencil grasp.

Fine Motor Activities to Improve Open Thumb Web Space

These web space hand activities will help improve an open web space for functional grasp:

1. Using a flexed IP joint of the thumb while encouraging thumb opposition is the number one best way to encourage an open thumb web space. The resulting rotation of the thumb and a tip-to-tip grasp will result in an open space that allows for improved dexterity.

2. Beading Activities- This activity with small beads and play dough is an easy way to strengthen these skills.

3. Fine Motor Crafts- Make and Take made these caterpillar pets that address bilateral coordination and an open thumb web space when threading the pony beads.

4. Threading Activities- Thread beads onto feathers like we did in this fine motor beading activity.

5. Tweezer Activities- Use homemade craft stick tweezers to encourage an open thumb space. Tweezer Games like Operation are a great way to work on this skill. Tweezer activities promote an open web space and stabilization of the thumb. 

6. Lacing Activities- Encourage an open thumb web space during lacing activities, like in this DIY lacing activities.

Here are more lacing card ideas that you can use to promote an open web space.

7. Pegboard Activities- Use a homemade pegboard to encourage an open thumb web space.

Web Space Hand Activities

An important piece of an open thumb space is the components that make up the skill. These include arch development, opposition of the thumb to the pointer finger, rotation of the thumb CMC joint, and flexion of the MCP and IP joints.

To encourage arch development try these web space hand movements try these activities:

  • Tearing small pieces of paper
  • Shaking dice within the hand
  • Rolling small pieces of play dough into balls

To encourage opposition of the thumb to the pointer finger and rotation of the thumb CMC joint, a child needs strength in the muscles of the thumb. The bulk of the thenar eminence allows for rotation, control, and endurance in activities with sustained thumb rotation.

Remember, while completing these activities, encourage the child to flex the thumb IP joint and to rotate the thumb to oppose the fingers. This promotes an open thumb web space, and not a squashed space!

A few toys that help encourage an open web space:

Amazon affiliate links are included below:

This Avalanche Fruit Stand from Learning Resources is a colorful way to encourage an open web space. The vertical surface is perfect for encouraging an extended wrist (see below).

Bead Sets: Stringing beads is a good way to encourage an open web space. The child must hold the bead and string between their thumb and index fingers. Collapsing of the thumb web space will happen when the child demonstrates weakness in the muscles of the thumb. Beading is a repetitive activity and promotes strength. 

This Melissa & Doug Deluxe Wooden Stringing Beads with over 200 beads from Melissa & Doug has over 200 beads in different colors and shapes, and even letters! You could even form sentences for the child to copy and practice their improved pencil grasp!

Rock ‘Em Sock ‘Em Robots: Often times, a child will wrap their thumb around the index finger when they are writing with a pencil. This indicates instability in the thumb and the muscles that allow for smooth pencil motions. Pushing down on the buttons of the Rock ‘Em Sock ‘Em ROBOTS Game from Mattel really strengthens the muscles of the thumb and allows for more stability leading to an open web space and ultimately more fluid motions of the pencil in letter formation. Plus, this game is just plain old FUN for kids of all ages!

Try these activities to improve open thumb web space needed for tasks like pencil grasp, in hand manipulation, and dexterity needed in fine motor activities.

More thumb web space hand activities

We’ve created many fine motor kits with lacing, pinch and crumbling paper activities, and tools to support fine motor development of the thumb web space:

Use these Fine Motor Kits for hands-on activity kits to develop fine motor skills, strength, dexterity, and manipulation. Kids LOVE these fine motor kits for the motivating activities. Therapists love them because it’s fresh, fun ways to work on pinch, grip, manipulation skills, and much more. Try some of these themed therapy kits:

Colleen Beck, OTR/L is an occupational therapist with 20+ years experience, graduating from the University of Pittsburgh in 2000. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. As the creator, author, and owner of the website and its social media channels, Colleen strives to empower those serving kids of all levels and needs. Want to collaborate? Send an email to contact@theottoolbox.com.

Sensory Processing Disorder Checklist

Sensory processing disorder checklists

Sensory processing disorder is a condition where the brain misinterprets sensory information so that the body responds in atypical ways. Sensory processing disorder can be broken down into different categories, but one thing is clear: interpretation of sensory input is “off”. Here, you will find a list of common sensory responses that might be seen with sensory processing disorder. Use this sensory processing disorder checklist to better understand responses to sensory input. It will be helpful to read this sensory processing disorder chart to get a bigger picture on this umbrella term.

Sensory checklists for each sensory system, great for identifying red flags for sensory processing disorder.

With sensory processing disorder, input from each of the sensory systems can be interpreted by the brain in different ways. Kids can hyper-respond or overreact to sensory input. Or, they can hypo-respond, or under-react to sensory information.

Sensory processing disorder can be seen in children or on adults.

These sensory processing disorder checklists are broken down by sensory system

Sensory Processing Disorder Checklist

Putting it all together – Let’s look at all of the sensory systems in a list:

  • Visual System (Sight)
  • Auditory System (Sound)
  • Tactile System (Touch)
  • Gustatory System (Taste)
  • Olfactory System (Smell)
  • Proprioceptive System (Position in space)
  • Vestibular System (Movement)
  • Interoceptive System (Inner body)

Typically, dysfunction within these three systems present in many different ways.  A child with sensory difficulties may be over- or under-responsive to sensory input.  They may operate on an unusually high or unusually low level of activity.  They may fatigue easily during activity or may constantly be in motion.  Children may fluctuate between responsiveness, activity levels, and energy levels.

Additionally, children with sensory processing dysfunctions typically present with other delays.  Development of motor coordination, fine motor skills, gross motor skills, social-emotional skills, behaviors, executive functioning skills, language, and learning are all at risk as a result of impaired sensory processing.

Sensory processing disorder checklists for responses seen to sensory input.

Sensory Processing Disorder Symptoms

It can be overwhelming when you start looking into various symptoms in sensory processing disorder. But if you are wondering about specific signs of SPD in your child, it can be helpful to have a comprehensive checklist of various areas that impact learning, play and functioning. 

The comprehensive list of sensory signs and symptoms listed below are helpful to spot an issue in your child, but more so can help you pinpoint a starting point with helping your child so you can support their needs.

Sensory Processing Disorder checklists for each sensory system

red Flags for Tactile Dysfunction

Tactile defensiveness, or tactile dysfunction refers to avoidance of certain textures or the seeking out of tactile sensory input. These indicators can mean a sensory issue with the tactile sensory system. Consider the sensory checklist based on the tactile system:

Hyper-responsiveness of the tactile sense may present in a child as over-responsiveness or overreaction to tactile sensation. This looks like:

  • Overly sensitivity to temperature including air, food, water, or objects
  • Withdrawing when touched
  • Refusing certain foods because of food texture issues
  • Dislike of having face or hair washed
  • Dislikes of hair cuts
  • Dislikes of having fingernails cut
  • Excessively ticklish
  • Avoidance to messy play or getting one’s hands dirty
  • Avoidance of finger painting, dirt, sand, bare feet on grass, etc.
  • Clothing preferences and avoidances such as resisting shoes or socks
  • Annoyance to clothing seams or clothing textures
  • Resistance to hair brushing
  • Over-reactive to unexpected touch
  • Overreactions to accidental or surprising light touches from others
  • Avoids affectionate touch such as hugs
  • Avoids washing hands at the sink
  • Difficulty with clothing fasteners like buttons, zippers, and belts
  • Challenges in the shower or bathtub with soap, washcloths preferences, and soap textures
  • Refuses to use glue

Hypo-responsiveness of the tactile sense may present in a child as under-responsiveness or under-reaction to tactile sensation. This may look like:

  • Seeks out tactile sensory input
  • Bumps into others
  • High pain tolerance
  • Stuffs food in mouth
  • Licks items or own skin
  • Not aware of being touched
  • Seems unaware of light touch
  • Startles easily when touched
  • When getting dressed, doesn’t notice clothing that is twisted
  • Tendency for self-abusiveness: biting self, rubbing self with heavy pressure, head-banging, pinching self, etc.
  • Doesn’t notice a runny nose, messy face, or messy hands
  • Puts items in the mouth
  • Lack of personal space
  • Runs into other children without noticing
  • Has difficulty maintaining space in line; bumps into others without noticing
  • Falls out of chair
  • NEEDS to touch everything
  • Uses a tight pencil grip on the pencil
  • Writes with heavy pencil pressure
  • Tears paper when cutting with scissors
  • Unintentionally rough on siblings, other children, or pets
  • Always touching others or things
  • Seeks out messy play experiences
  • Prefers to rub or feel certain textures
  • Difficulty with fine motor tasks
  • Craves touch
  • Doesn’t seem to notice unexpected touch
  • Constantly playing in the soap or water at the sink

red Flags for Proprioception Dysfunciton

The Proprioception Sensory System is the recognition and response to the body’s position in space with an internal feedback system using the position in space of the joints, tendons, and muscles.  This sensory system allows the body to automatically react to changes in force and pressure given body movements and object manipulation.  The body receives more feedback from active muscles rather than passive muscle use.  Related to the proprioception system is praxis or motor planning.  Individuals are able to plan and execute motor tasks given feedback from the proprioceptive system. Praxis allows us to utilize sensory input from the senses and to coordinate hat information to move appropriately.

Hyper-responsiveness of the proprioception sense may present in a child as over-responsiveness or overreaction to proprioceptive sensation. This may include postural insecurity. This may look like:

  • Uses too little pressure when writing or coloring
  • Prefers soft or pureed foods
  • Appears lethargic
  • Bumps into people or objects
  • Poor posture, slumps in their seat
  • Poor handwriting
  • Inability to sit upright when writing or completing desk work; Rests with head down on arms while working
  • Poor awareness of position-in-space
  • Frequent falling
  • Clumsiness
  • Poor balance
  • Poor body awareness
  • Poor attention
  • Poor motor planning
  • Uses extreme force during tasks
  • Challenged by clothing fasteners ( how much force to use with fastening buttons, zippers, and belts, or snaps)

Hypo-responsiveness of the proprioceptive sense may present in a child as under-responsiveness or underreaction to proprioceptive sensation. This looks like:

  • Uses excessive pressure when writing or coloring
  • “Jumper and crasher”- seeks out sensory input
  • Can’t sleep without being hugged or held
  • Bumps into people or objects
  • Seems aggressive
  • Grinds teeth
  • Walks on toes
  • Chews on pencils, shirt, sleeve, toys, etc.
  • Prefers crunchy or chewy foods
  • Cracks knuckles
  • Breaks pencils or crayons when writing or coloring
  • Pinches, bites, kicks, or headbutts others
  • Difficulty with fine motor skills
  • Poor handwriting
  • Poor awareness of position-in-space
  • Stomps their feet on the ground when walking
  • Kicks their chair or their neighbors chair in the classroom
  • Frequent falling
  • Clumsiness
  • Poor balance
  • Constantly moving and fidgeting
  • Poor attention
  • Uses extreme force
  • Has unexpected bruises
  • Seeks out wrestling games

red Flags for Vestibular Dysfunction

The Vestibular Sensory System is the sense of movement and balance, and uses the receptors in the inner ear and allows the body to orient to position in space.  The vestibular system is closely related to eye movements and coordination.  Vestibular sensory input is a powerful tool in helping children with sensory needs.  Adding a few vestibular activities to the day allows for long-lasting effects.  Every individual requires vestibular sensory input in natural development.  In fact, as infants we are exposed to vestibular input that promotes a natural and healthy development and integration of all systems. 

Vestibular dysfunction and problems with the Vestibular Processing System can present as different ways:

  • Poor visual processing
  • Poor spatial awareness
  • Poor balance
  • Difficulty with bilateral integration
  • Sequencing deficits
  • Poor visual-motor skills
  • Poor constructional abilities
  • Poor discrimination of body position
  • Poor discrimination of movement
  • Poor equilibrium
  • Subtle difficulties discerning the orientation of head
  • Trouble negotiating action sequences

Hyper-responsiveness of the vestibular sense may present in a child as over-responsiveness or overreaction to vestibular sensation. This look may look like:

  • Experiences gravitational insecurity
  • Overly dizzy with motions
  • Resistant to moving activities such as swings, slides, elevators, or escalators
  • Fear of unstable surfaces
  • Unable to tolerate backward motions
  • Unable to tolerate side to side motions
  • Illness in moving vehicles
  • Avoids swings or slides
  • Gets motion sick easily
  • Appears “clingy”
  • Refuses to move from the ground (i.e. jumping or hopping activities)
  • Difficulty/fear of balance activities
  • Refusal to participate in gym class
  • Refusal to try playground equipment
  • Fearful on bleachers or on risers
  • Fear or dislike of riding in elevators or escalators
  • Fearful of movement
  • Dislike of spinning motions
  • Avoids chasing games
  • Overly fearful of heights
  • Nauseous when watching spinning objects
  • Poor posture
  • Easily fatigued
  • Poor coordination
  • Low muscle tone
  • Poor motor planning
  • Fearful when a teacher approaches or pushes in the child’s chair
  • Clumsiness
  • Poor attention
  • Difficulty or fearful on stairs
  • Fearful during situations of constant motion
  • Struggles or fearful on ladders
  • An extreme dislike of high places
  • Refuses to sit on or try a bike

Hypo-responsiveness of the vestibular sense may present in a child as under-responsiveness or underreaction to vestibular sensation. This may look like:

  • Constant movement including jumping, spinning, rocking, climbing
  • Craves movement at fast intervals
  • Craves spinning, rocking, or rotary motions
  • Poor balance on uneven surfaces
  • Constantly fidgeting
  • Increased visual attention to spinning objects or overhead fans
  • Bolts or runs away in community or group settings, or when outdoors or in large open areas such as shopping malls
  • Difficulty maintaining sustained attention
  • Impulsive movement
  • Constantly getting up and down from desk in the classroom
  • Walks around when not supposed to (in the classroom, during meals, etc.)
  • Loves to be upside down
  • Head banging
  • Hypermobile or all over playground equipment
  • Leans chair back when seated at a desk
  • Loves spinning
  • Rocks self-back and forth when seated
  • Poor posture
  • Poor coordination
  • Poor motor planning
  • A deep need to keep moving in order to function
  • Frequent falling
  • Clumsiness
  • Poor balance
  • Poor attention
  • Always in constant motion
  • Prefers being in high places

Red Flags for Visual SYSTEM Dysfunction

Eighty percent of the information we receive from our environment is visual.  When perception of this information is not processed correctly, it can create an altered state that influences many areas:  eye-hand coordination, postural reflexes, and vestibular processing are all influenced and reliant upon the visual system. 

The visual system is the sensory system that most individuals rely upon most heavily for daily tasks.  Visual information is perceived by cells in the back of the eye.  These cells (rods and cones) relay and transfer light information into information that is transferred to the central nervous system.  These photoreceptors are able to perceive day time vision and night time vision, with adjustments to sensitivity of light intensity.  They are able to respond to different spectrum of color and differentiate color information.  The rod and cone cells, along with the retina, process a great deal of visual information in the neural structure of the eye before transmitting information to the central nervous system. 

The relay of information from the eyes to the central nervous system are made up of three pathways.  Pathways project to different areas of the brain and allow for:

  1. Processing and recognition of faces/shapes/motion (the “what” and “where” of objects)
  2. Integration of information in order to coordinate posture and eye movements
  3. Oculomotor adaptation.

Hyper-responsiveness of the visual sense may present in a child as over-responsiveness or overreaction to visual sensation. This may look like:

  • Complains of lights being too bright
  • Unable to tolerate certain lighting such as fluorescent overhead lights
  • Struggles with sudden changes in lighting
  • Challenged by bright or flashing lights
  • Colorful lights “hurt” the eyes
  • Complains of headaches in bright light
  • Complains of the “glow” of unnatural lighting
  • Distressed by light sources
  • Sensitive to light
  • Sensitive to certain colors
  • Distracted by cluttered spaces
  • Avoids eye contact
  • Trouble with puzzles
  • Frustration at the movies
  • Difficulty reading
  • Difficulty finding objects in a busy drawer

Hypo-responsiveness of the visual sense may present in a child as under-responsiveness or underreaction to visual sensation. This looks like:

  • Attracted to spinning objects
  • Difficulty with visual perception
  • Difficulty with eye-hand coordination
  • Difficulty with reading and writing
  • Holds or presses hands on eyelids in order to see flashing lights
  • Squints or presses eyelids shut
  • Flaps hands or objects in front of eyes
  • Holds eyes at the movies

red Flags for Auditory SYSTEM Dysfunction

Receptors for the auditory system are located in the inner ear and are responsible for receiving vibration from sound waves and changing them to fluid movement energy.  Information is projected to the central nervous system and transmits sound frequency as well as timing and intensity of sound input.  The auditory system is integrated with somatosensory input in order to play a role in controlling orientation of the eyes, head, and body to sound. 

Hyper-responsiveness of the auditory sense may present in a child as over-responsiveness or overreaction to auditory sensation. This may look like:

  • Startles easily to unexpected sounds
  • Dislikes noisy places
  • Overly sensitive to speakers on radios
  • Fearful of smoke detectors, overhead speakers
  • Shushes others or asks others to stop talking
  • Holds hands over ears
  • Sensitive to certain sounds such as lawnmowers or the hum of the refrigerator
  • Easily distracted by sounds and background noise
  • Hums to block out background noise

Hypo-responsiveness of the auditory sense may present in a child as under-responsiveness or underreaction to auditory sensation. This looks like:

  • Seems to be unaware of sounds
  • Holds radio speakers up against ears
  • Doesn’t respond to alarms
  • Makes silly sounds at inappropriate times or frequently
  • Mimics sounds of others
  • Talks to self
  • Difficulty locating sounds, especially when in a noisy environment
  • Hums in order to hear the sound of humming

red Flags for Gustatory System Dysfunction

The gustatory system perceives input through the tongue.  Taste cells in the mouth perceive five sensations: salty, sweet, bitter, sour, and savory.  The gustatory system is closely related to the sense of smell and proprioception.  How we perceive taste is deeply influenced by the sense of smell. 

While many children with sensory needs have a tendency to chew on their shirt collars or pencils as a sensory strategy in order to seek proprioception needs, the behavior may occur as a result or as a reaction to under-responding to oral input.  Other children may seek out intense taste sensations and in that case put non-edible items into their mouth to satisfy that sensory need.  Still other children may over-respond or under-respond to certain flavors or taste sensations.  For those children, it is common to experience food refusal related to texture or taste.

Hypersensitivity to oral sensory input may present in a child as over-responsiveness or overreaction to gustatory sensation. This looks like:

  • Dislike of mixed textures (cereal in milk or chunky soup)
  • Resistant to trying new foods
  • Avoids certain textures
  • Avoids straws
  • Avoidance of specific food or drink temperatures
  • Picky eating
  • Preference for bland foods
  • Avoids temperature extremes (unable to tolerate hot or cold foods)
  • Prefers foods that do not touch or mix on their plate
  • Use of only a specific spoon or fork or no utensil at all
  • Intolerance to teeth brushing.
  • Anxiety or gagging when presented with new foods
  • Drooling

Hypo-responsiveness of the gustatory sense may present in a child as under-responsiveness or underreaction to gustatory sensation. This may look like:

  • Licking objects
  • Bites others
  • Chews on clothing
  • Hums all the time
  • Prefers a vibrating toothbrush
  • Prefers spicy foods
  • Stuffs food into cheeks
  • Prefers food very hot or very cold temperature

red Flags for Olfactory System Dysfunction

The olfactory system, or the system that enables the sense of smell, has receptors in the tissue of the nose that are connected by pathways to the brain.  Connections occur via two pathways, one being a direct route to neurons in the brains and the second being a path that passes near the roof of the mouth.  This channel is connected to the taste of foods.

There is some evidence indicating that the sense of smell is more associated with memory than the sense of vision or the other senses.  The connection of the olfactory sense to the emotional part of the brain and previous experiences, as well as hypersensitivity or hyposensitivity to smells can cause anxiety or sensory related breakdowns in children with sensory processing difficulties. 

Hyper-responsiveness of the olfactory sense may present in a child as over-responsiveness or overreaction to olfactory sensation. This may look like:

  • Overly sensitive to smells
  • Notices smells others don’t
  • Anxious around certain smells
  • Holds nose in response to certain scents
  • Challenged in the shower or bathtub, with overwhelming preferences and disliking certain scents

Hypo-responsiveness of the olfactory sense may present in a child as under-responsiveness or underreaction to olfactory sensation. This may look like:

  • Smells unusual items like paper or certain materials
  • Prefers strong scents

Red Flags for Interoceptive System Dysfunction

The interoceptive sensory system is an area that most people are not as familiar with.  This system is connected to amygdala, the emotional system, the limbic system, our emotional awareness, our feelings, and subconscious arousal.  Receptors for the interoceptive system are in our organs and skin.  The receptors relay information regarding feelings such as hunger, thirst, heart rate, and digestion to the brain.  This is the foundation to sensations such as mood, responding to the moods and emotions of others (co-regulation), emotions, aggression, excitement, and fear and in turn, promotes the physical response of our bodies. 

Physical responses include functions such as hunger, thirst, feelings, digestion, heart rate, and body temperature.

Hyper-responsiveness of the interoceptive sense may present in a child as over-responsiveness or overreaction to interoceptive sensation. This may look like:

  • High pain tolerance
  • Distracted and overwhelmed by feelings of stress
  • Distracted or overly sensitive to sensations of stomach digestion
  • Distracted or overly sensitive to sensation of heart beat
  • Always hungry or thirsty
  • Eat more and more often to avoid feelings of hunger
  • Unable to sense the feeling of being full; overeats or overdrinks
  • Overwhelmed by feelings of sadness, anger, happiness, etc. and unable to respond appropriately
  • High urine output
  • Use the bathroom more often than necessary to avoid feelings of a full bladder or bowel
  • Distracted by changes in body temperature
  • Distracted and overly sensitive to sweating
  • Overly sensitive to feeling ticklish or itchy
  • Overly sensitive to cold or heat
  • Overly sensitive to signs of illness
  • Fearful of vomiting

Hypo-responsiveness of the interoceptive sense may present in a child as under-responsiveness or underreaction to interoceptive sensation. This may look like:

  • Low pain tolerance
  • Poor or low response to interoceptive stimuli
  • Doesn’t know when to go to the bathroom
  • Never says they are hungry or thirsty
  • Does not drink or eat enough
  • Difficult to toilet train
  • Never complains of being cold or hot (always wears shorts in the winter or pants in the summer)
  • Never complains of sickness
  • Difficulty falling asleep
  • Unable to identify feelings of stress
  • Unable to identify specific feelings and appropriate responses

Sensory Checklists, explained

There is a lot to think about here, right? Taking a giant list of common sensory processing disorder lists and knowing what to do with that list is complicated. What if you had strategies to address each sensory system’s over-responsiveness or under-responsiveness so you could come up with a sensory diet that helps kids function?

In The Sensory Lifestyle Handbook, I do just that.

The Sensory Lifestyle Handbook

Sensory processing is broken down by sensory system so you can understand what you are seeing in the sensory responses listed above. Then, you can use the lists of sensory activities to help the child complete functional tasks while they get the sensory input they need to focus, organize themselves, and function.

The sensory activities are presented as meaningful and motivating tasks that are based on the child’s interests, making them motivating and meaningful.

You can get the Sensory Lifestyle Handbook and start building a sensory diet that becomes an integrated part of each day’s daily tasks, like getting dressed, completing household chores, school work, community interaction, and more.

Get your copy of The Sensory Lifestyle Handbook here.

Sensory checklists in early intervention

In young children, sensory issues can present leading to the early intervention process. Characteristics of sensory issues show up during these young years. You may see frustration or meltdowns due to unexpected touch. You may identify tactile defensiveness even in the infant years when babies pull away from heavy input of a cuddle or wrapped blanket. You may notice sensory preferences in the way of seeking out a pacifier for comfort (long beyond the typical pacifier stage). You may even identify distress with certain aspects of sensory input as listed in the sensory processing checklists above.

A few helpful resources are listed below:

Meltdowns– This blog post covers temper tantrums verses sensory meltdowns.

This blog post on early intervention strategies for sensory differences covers important information for sensory needs during the infant to 5 years range.

Sensory integration at the playground – Exploring different sensory input areas at the playground can help identify sensory challenges in young children.

A Final Note on Examples of Sensory Processing Dysfunction

This extensive list of sensory red flags is meant to act as an educational tool for parents, educators of children.

As occupational therapists, we strive to support children and their “team” of parents, caregivers, family, and educators with resources and information that will serve the individual child so that they can function in everyday life tasks. 

The purpose of this sensory processing disorder checklist is to help parents and professionals who interact with children become educated about particular signs of sensory processing dysfunction.

A checklist is not to be used as the absolute diagnostic criteria for labeling children with sensory processing disorder. It is simply a resource to be used as a starting point when identifying distress symptoms to explore further. 

If you have difficulty understanding your child’s sensory preferences, sensory avoidances, use this sensory processing disorder checklist as a starting point and reach out to a pediatrician and pediatric occupational therapist.

Colleen Beck, OTR/L is an occupational therapist with 20+ years experience, graduating from the University of Pittsburgh in 2000. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. As the creator, author, and owner of the website and its social media channels, Colleen strives to empower those serving kids of all levels and needs. Want to collaborate? Send an email to contact@theottoolbox.com.

Adults With Executive Function Disorder

Resources for adults with executive function disorder

Here, you will find tools and information for adults with executive function disorder and executive functioning issues that impact day to day tasks in adulthood. For adults, executive functioning skills are a part of everything we do. They impact the way we pay attention, focus, plan, and prioritize. Here, you’ll find strategies that can impact executive functioning needs so that organization, impulse control, planning, time management, and other executive functioning skills are improved and regulated in daily life tasks.

Adults with Executive Function Disorder

Now you might be thinking, “Executive function disorder?! I don’t have a disorder!” And that is probably the case in most instances for those reading this article. However, there are many of us who struggle on a day to day basis with things like getting started on chores or problems (task initiation), staying focused (attention), losing things constantly (organization), getting out of the house on time on a regular basis (task completion), and a variety of other challenges that impact our lives and generally stress us out. These are not the components that define a disorder, but they are executive functioning challenges that impact day to day life. It’s my hope that this resource offers tools to make the overall wellbeing better, and to offer tools for adults with executive function challenges easier!

Let’s break down executive functioning skills in adults and take a look at how things like focus, attention, organization impact life skills in adulthood.

My daughter has battled Executive Function Disorder all of her life, but right now, it is really preventing her from moving forward with her life. Things like completing a task, making decisions, time management, and projecting ahead are SO HARD. Is there anything that can help my adult daughter struggling with executive functioning disorder?

Does this sound at all familiar? So often, executive functioning challenges are present in adults but we don’t stop and think, this isn’t how things have to be. In fact, there are everyday challenges that are very difficult for adults with executive functioning needs. Things like organization, planning, and flexible thinking can be a real struggle that impacts family life, work life, personal relationships, and the things we need to do every day.

As kids with these challenges move into adulthood, some areas that we might expect to develop just never seem to change. It’s not uncommon; the fact is that executive functioning skills are a very broad set of skills. Forgetting things, difficulty with inhibiting behaviors or actions, trouble with planning big projects, or staying organized in the daily life of an adult…everyone deals with these challenges at one time or another.

The challenges become a problem when  social, emotional, intellectual, or organizational aspects are disrupted.  A person’s career/job/family life/etc. can be devastated by difficulties with executive functioning skills. 

Difficulties with the higher-level cognitive skills that make up executive function can impact adults by limiting one’s ability to “connect the dots” and can impact other areas of executive functioning as well. 

For the adult with executive function disorder, challenges can present in many different ways. There may be no trouble with impulsivity or attention struggles, however other mental skills can be quite difficulty. Sometimes, seeing the “big picture” is the problem. For others, it’s just making decisions. Still others lack time management and have difficulty with multi-tasking.   

Adults with executive function disorder can struggle with organization, trouble with planning, prioritization, etc.Here are tools and strategies to help the adult with executive function problems.i

Executive Function in Adults

Here’s the thing: There is a lot of information out there for kids who are struggling with these areas. However, for most of us, executive functioning skills are still developing well into the adult years.

Executive function in adults is developmental. In fact, executive function skills don’t typically develop until the early 20s. Development of executive functioning skills occurs up through the college years (and beyond), making that transition from the home setting of high-school into a college dorm very difficult for many. 

So, for some adults who are challenged in these areas, there can be simply a few accommodations or strategies put into place. Simply using a few set of tools designed to address these needs can allow for improved skills like organization and time management which are then carried over to other areas.   

Making changes to executive function in adults can mean looking at the big picture.

Adults need to do adult things, right? Areas of life skills where executive functioning skills impact “getting things done” include:

  • Obtaining a job
  • Maintaining a job
  • Creating personal relationships
  • Maintaining personal relationships
  • Sustaining a clean and safe home
  • Completing large home projects (inside the home and outside the home)
  • Shopping
  • Paying bills
  • Transporting oneself to work, the community
  • Making healthy choices
  • Cooking and cleaning up food
  • Taking medications
  • Contributing to the community
  • Caring for children

When you think about the life changes that happen between high school graduation to accomplishing all of these high-level executive functioning skills, you can see how there is a developmental change that occurs between the ages of 18-25.

Executive Functioning Skill Components

In order to complete high-level thinking and planning tasks, adults require development of several executive functioning areas:

  • Planning
  • Prioritization
  • Attention
  • Organization
  • Task Completion
  • Task Initiation
  • Problem Solving
  • Working Memory
  • Self-control
  • Flexibility
  • Self-awareness

For other adults who may have always struggled with seeing the big picture, planning tasks, or staying focused on a task, this is the typical development for that individual. In other words, some adults may be gaining improvements and strengthening the skills they’ve got, just at a lower level than another adult. In these cases, strategies and tools can make a difference here, too. 

Adults and distractibility 

We are distracted by many things, and that level of distractibility is impacted by advances in screens, stimuli around us, faster lifestyles, more options, and increasing availability of information.

Some good resources to check out on adults and distractibility include:

Below, you will find curated information from around the web that will be instrumental in making an effortful improvement in executive functioning needs. Read through this information and use it as best fits the needs you or an adult with executive functioning challenges might be experiencing.  

Remember that everyone is different in their strengths, weaknesses, needs, interests, and experiences. This information is not intended to treat or address specific needs, but rather, as educational material. Seek professional help when needed.   

Adult Executive Functioning Disorder

The is fact that adult executive functioning impacts everything we do as adults. Take a look at this adult executive functioning skill checklist.

Some of these problem areas for adult executive functioning issues may include:

  • Difficulty making plans
  • Difficulty making decisions
  • Time management
  • Trouble with organization
  • Difficulty keeping important papers organized
  • Trouble prioritizing 
  • Poor emotional control 
  • Difficulty with flexible thinking
  • Trouble thinking “on the spot”
  • Trouble using a schedule
  • Trouble getting out of the house on time
  • Trouble with impulsive buys
  • Difficulty paying bills on time
  • Difficulty with losing keys or important items
  • Trouble following through with plans
  • Trouble picking the most important tasks
  • Trouble doing the important parts of tasks first
  • Trying to do too much at once
  • Constantly running late
  • Difficulty listening to a person talking without thinking of other things
  • Easily frustrated
  • Forget the last step/steps in a multi-step task

It’s easy to see how the list above can look so different for different people, especially when considering aspects such as job requirements, family obligations, outside situations or other issues that may make a difference in the occupational performance of an individual.   

Executive Functioning Skills and Emotions

Executive functioning kills and emotional regulation are closely related. Playing a role in the ability to function and complete day-to-day tasks is the role of the limbic system when it comes to executive functioning skills. Managing emotions, and emotional regulation can greatly impact the adult with executive function challenges.   

These structures and their hormones control functions such as emotions, behavior, motivation, sleep, appetite, olfaction, stress response. In adults, the role of the limbic system impacts household tasks completed, grocery shopping, paying bills, getting to work on time, caring for children and other daily life tasks.

This is really interesting, because you may connect the dots with this list and see that social emotional skills, executive functioning, inner drives, and sensory processing (including the sense of smell and interoception) all centered in one place in the brain! (This is not to say that these are the only places in the brain that operate these functions as well.) All of this can be considered when addressing needs using a specific sensory diet for adults that center on the areas of needs for the individual struggling with executive functioning skills.

You can see how the role of emotions and regulating daily stressors impacts attention, organization, task initiation, task completion, and problem solving.

Generally speaking, the limbic system is the emotional brain but this piece of the EF puzzle has a huge role for adults who are expected to act…like adults!

Adults with executive function disorder can struggle with organization, trouble with planning, prioritization, etc.Here are tools and strategies to help the adult with executive function problems.i

Tips for adult executive functioning

Some easy to apply tools can impact executive functioning challenges in adults. These strategies include low-tech or high-tech strategies such as:  

  • Use a paper planner or calendar to keep track of obligations
  • Set up a filing system to keep track of and manage mail and important papers
  • Use highlighters and colorful sticky notes to make a visual organization system
  • Use apps to stay organized. Here are some Alexa Skills that can help with executive functioning skills like organization, etc.
  • Set up calendar reminders on a phone or smartwatch
  • Set up automatic payment plans for bills
  • Brainstorm routines and weekly/daily tasks and strategies to make decision-making less stressful and easier
  • Think through and visualize the day or week ahead and predict any challenge that may arise
  • Create routines and calendars for ongoing tasks
  • Create brain dumping lists for big tasks and set goals with specific dates and timelines
  • Use a daily journal to track each day’s events. The Impulse Control Journal can be used by adults as well as kids. The “look” of the journal is not childish, and has many components that can translate to an adult’s needs in promoting organizational, time management, etc. 

Resources for Adults with Executive Function Disorder

Here are some symptoms of executive function disorder in adults. Some of the symptoms include time blindness, self-motivation, and an inability to keep future events in mind. Do these symptoms sound familiar?

One symptom that is mentioned is the regulation of one’s non-verbal working memory, or our inner critic. This is an area that can be detrimental to some, especially when self-conscious of weaknesses that impact life choices or struggles.  Here is one simple strategy for self-talk in kids, but can be morphed into an age-appropriate version for adults. 

If an adult or someone who is trying to help an adult with executive function needs would like to look into testing, here is a self-test that may help with self-awareness of the problems that can easily be addressed through strategies and tools. Use this information to move forward with professional help if necessary. 

Another article that can “bring to light” some of the concerns with executive functioning needs is this article about the day in the life of an adult with EFD. It really highlights the challenge of managing other people’s schedules, the workplace juggling act, and managing relationships.

Time management tools, including simple planners and time management apps can be helpful. Here are more tools for addressing time management and other tools such as motivation, scheduling, prioritization, and other challenges. 

This article discusses ADHD, but a lot of the tips and strategies can carryover to any need with planning ahead.

Finally, remember that many of the executive functioning strategies that are out there and presented in books can be used just as easily and seamlessly by adults. The same strategies that work for keeping track of homework tasks by a child can be used by an adult who needs to manage bills and important papers. 

How to plan and prioritize tasks

The Impulse Control Journal is your guide to addressing the underlying skills that play into trouble with planning and prioritization. 

The journal is an 80 page collection of worksheets and prompts to discover what’s really going on behind executive functioning skills like planning, organization, prioritization, working memory, and of course, impulse control. 

While the guide was developed for students of all ages, this printable workbook is perfect for adults, too. It can help you discover strategies that make a real impact for all of the skills needed to get things done. 

Here’s the thing; Everyone is SO different when it comes to struggles related to executive functioning and everyone’s interests, needs, challenges, strengths, and weaknesses are different too. All of these areas play into the challenges we see on the surface. And, this is where the Impulse Control Journal really hits those strengths, weaknesses, and challenges where it matters…in creating a plan that really works for kids of all ages (and adults, too!)

Check out the Impulse Control Journal, and grab it before the end of February, because you’ll get a bonus packet of Coping Cards while the journal is at it’s lowest price. 

Read more about The Impulse Control Journal HERE
The Impulse Control Journal has been totally revamped to include 79 pages of tools to address the habits, mindset, routines, and strategies to address impulse control in kids.    More about the Impulse Control Journal:

  • 30 Drawing Journal Pages to reflect and pinpoint individual strategies 
  • 28 Journal Lists so kids can write quick checklists regarding strengths, qualities, supports, areas of need, and insights 
  • 8 Journaling worksheets to pinpoint coping skills, feelings, emotions, and strategies that work for the individual 
  • Daily and Weekly tracking sheets for keeping track of tasks and goals 
  • Mindset,Vision, and Habit pages for helping kids make an impact 
  • Self-evaluation sheets to self-reflect and identify when inhibition is hard and what choices look like 
  • Daily tracker pages so your child can keep track of their day 
  • Task lists to monitor chores and daily tasks so it gets done everyday  
  • Journal pages to help improve new habits  
  • Charts and guides for monitoring impulse control so your child can improve their self confidence
  • Strategy journal pages to help kids use self-reflection and self-regulation so they can succeed at home and in the classroom  
  • Goal sheets for setting goals and working to meet those goals while improving persistence  
  • Tools for improving mindset to help kids create a set of coping strategies that work for their needs  

This is a HUGE digital resource that you can print to use over and over again.

 
 
 
 
These tips and strategies to help with executive functioning skills can be used by adults who are challenged with difficulty in planning, prioritization, organization and other cognitive skills.

What does executive function disorder look like in adults?

Things like distraction, time blindness, distractibility, and attention or organization issues can be common in adults with executive function disorder. Here are other signs of EF issues in adults:

  • Time blindness– being unaware of the passing of time (see below for more information)
  • Trouble remembering names
  • Losing or misplacing everyday items such as purse, wallet, keys, phone
  • Difficulty completing multi-step tasks such as laundry
  • Late for appointments consistently
  • Difficulty breaking tasks down into steps
  • Trouble completing tasks that need done daily such as hygiene, grooming, making the bed, etc.
  • Forgetting to pay bills month after month
  • Consistently forgetting to take out the trash on trash day
  • Misplacing items
  • Unable to multitask

Can executive function be improved in adults?

This can be a difficult question to answer because of the multitude of way’s that an executive functioning difficulties present themselves in adults. There are just so many functional tasks that can be broken down into functional participating.

When taking into consideration the skill areas that make up executive functioning skills, addressing the areas of working memory, attention, organization, prioritization, planning, self-motivation, emotional regulation, problem solving, inhibition…there are many areas to work on when it comes to improving executive functioning skills in adults.

This is to say, however, that it is possible to make habit changes, adaptations, and cognitive, behavioral changes that improve the ability to complete tasks. In the ault with executive functioning disorder, working on small steps and through tools such as lists, organizational changes, executive function coaching, apps, or progress planners, it is possible to make positive changes in the tasks that are impacted by executive functioning issues.

Here are some action plans that can be used to improve executive functioning skills in adults:

  • Use lists
  • Work on one task for the day
  • Use colored markers and a planner to organize how time is spent
  • Create a morning, evening, and study routine
  • Have clear goals 
  • Plan ahead for the day by working off an organizer and checklists
  • Use a time management app to reduce distractions
  • Work on saying “no” to to distractions
  • Manage stress using coping strategies, self-regulation, exercise, sleep, nutrition
  • Exercise regularly
  • Develop working memory strategies and mental flexibility
  • Problem solve
  • Work on self-motivation skills
  • Write a letter to future self as a strategy to visualize a future you would like to achieve
  • Identify strategies to cope and regulate moods better
What is time blindness and how to work on this executive functioning issue in adults.

What is time blindness?

Time blindness refers to the concept of being unaware of time passing.

In most cases, adults and teens (as they develop) are aware of time and have the ability to track its passing. This allows us to move through the morning routine to get out the door on time. It allows us to complete tasks and make it to appointments. It allows us to complete each step of a meal preparation so that dinner is on the table at a reasonable time.

You may recognize time blindness by recognizing that “time got away from you”. We all have felt the impact of time blindness when we say “time flies”.

However, some individuals have a difficult time with time awareness, and “time blindness”.

Time blindness becomes an issue for some individuals when they are consistently late leaving the house for appointment, or when late from returning from a break. Time blindness, when severe, can impact health, social participation, responsibilities, or safety.

Some exaples of time blindness include:

  • Missing appointments
  • Taking too long to get started on a task
  • Taking too long to get ready in the morning
  • Sitting on a phone or device without realizing how much time has passed (This is a BIG one!)
  • Not realizing how much time a task will take to complete (such as meal preparation)
  • Getting “sucked into” a leisure activity such as watching Netflix, playing a game on a device, watching YouTube, or talking with friends

How to Deal with Time Blindness

While time certainly does fly, we can make some simple changes that deal with time blindness that might impact function, safety, and participation in daily tasks and responsibilities.

  1. Use a timer. The timer app on your phone can be used for a simple task or to use during recreational tasks such as watching YouTube videos. When the timer goes off, turn off the videos and move on to what you need to get done.
  2. Keep track of how long things take and write it down in a planner or journal. Refer back to that time tracker when planning a day.
  3. Use a planner with time slots for the day. Mark down appointment times and mark off how much time it takes you to drive to the location, get ready, eat meals. Be sure to add a small cushion time in your time planner for things like gathering a purse, putting on shoes, or gathering your keys and phone.
  4. Use a clock- wear a wrist band so that the time is always on you. There are smart watches available that offer a vibration as a physical notification.
  5. Make the clock app on your phone show up on the screensaver face of your smart phone.
  6. Break a larger task such as laundry or meal prep into smaller tasks.
  7. Create a system. Tasks such as shopping for groceries can fall into the time blindness category. Set up a shopping system and then a putting away the groceries system. Use what works for you.
  8. Use a Pomodoro app to keep track of how long you are working on a particular task. Use the break period, and then get back to the task.

In summary, addressing skill areas such as organizational skills, time-management skills, focus, memory, goal-setting abilities, and general well-being can have a huge impact on adults struggling with executive function challenges.

Colleen Beck, OTR/L is an occupational therapist with 20+ years experience, graduating from the University of Pittsburgh in 2000. Colleen created The OT Toolbox to inspire therapists, teachers, and parents with easy and fun tools to help children thrive. As the creator, author, and owner of the website and its social media channels, Colleen strives to empower those serving kids of all levels and needs. Want to collaborate? Send an email to contact@theottoolbox.com.

Early Intervention for Sensory Differences

Early intervention and sensory differences

Our sensory system is very complicated. A lot of times when we hear about sensory, we think about our 5 senses (taste, touch, sight, smell and hearing.) This blog will take us into a deep dive of early intervention for sensory differences and the definition of different sensory processing areas. Early Intervention services provide supports for children birth through age three who demonstrate developmental delays.

These delays could be caused by a variety of reasons, from autism, chromosome abnormalities, drug exposure, prematurity, motor impairments, language delays and more. 

Early intervention for sensory differences

Early Intervention for Sensory Differences

One of the areas that is always assessed when determining if a child is eligible for Early Intervention services is the area of sensory processing. These areas include Low Registration, Sensation Seeking, Sensation Sensitivity, and Sensation Avoidance. Also addressed are the areas of Sensory and behavioral including general, auditory, visual, touch, movement, oral and behavioral differences.

We will explore these areas in more detail throughout this blog post. Sensory diets are one of the most common and impactful ways to support children with sensory differences.

This article describes sensory diets as “A sensory diet is a set of activities that make up a sensory strategy and are appropriate for an individual’s needs.  These are specific and individualized activities that are scheduled into a child’s day and are used to assist with regulation of activity levels, attention, and adaptive responses.  Sensory diet activities are prescribed based on the individual’s specific sensory needs.”

There are four quadrants in a sensory profile. This visual clearly defines the similarities and differences between seeking, sensitivity, registration and avoidance.

The infant/toddler sensory profile is a common assessment used to determine the needs of a child in the following areas If a child is over-responsive to sensory input, they would fall in the sensory seek or slow to register sensory input sections. If a child is under responsive to sensory input, they would fall in the sensory sensitive or sensory avoider sections. 

What are sensory differences  and neurodiversity? This article explains.

What are sensory differences?

These areas of sensory diversity make up the term sensory differences. Beyond the four quadrants, however, there are other sensory differences to consider. These are described below.

All of these sensory differences described are part of the neurodiversity of human life. We all are different when it comes to sensory, and we are all sensory. Just like the diversity of physical attributes, personal preferences, characteristics, sensory differences are just one more difference that makes us who we are.

Sensory Seeking

This area determines if a child seeks out sensory input. If a child is scored higher than most in this area, you may see them move around more, look at items that spin (such as fans or toys with wheels) be attracted to fast paced and brightly colored television shows.

Here are some wonderful home ideas for children who are sensory seekers.

Sensory Sensitivity

This area determines a child’s ability to notice different senses. If a child scores higher than most in this area, you may see a child always needing a routine to stay calm, startle to certain sounds, become upset during routine hygiene activities (such as getting hair brushed or nails trimmed) and significant preferences on types and textures of foods.

Here are some ways to support children in a controlled way, who show needs in the sensitivity area.

Sensory Registration

This area determines how a child responds to sensory input from others or their environment. This article by the pediatric development center explains how important registration is for a child’s functioning and learning.

It describes registration as: “Sensory registration is the process by which children respond or attend to sensory input in their environments.  The nervous system must first notice the sensory information, once registered the memory compares it to things they have heard or seen, and thus gives new information meaning.  Children who fail to respond or have delayed responses to sensory information have diminished sensory registration.  Diminished sensory registration is often associated with one or two weaker sensory systems, such as the auditory or vestibular system.  Without sensory registration, no other learning can take place.”

If a child scores higher than most in this area, you may see a child miss sensory input more than others do. A child in this section may miss eye contact, pay attention to only specific tones, and ignore most sounds. These children are harder to engage or seem uninterested in activities. They may need tactile, auditory and visual cues to initiate engagement in conversation or an activity.

Here are some ways to support children with low registration.

Sensory Avoidance

This area determines how a child’s need to control the amount and type of sensations at any given time. If a child scores higher than most in this area, you may see a child resist playing with other children due to overwhelm, resist being cuddled when it’s not on their terms, frequently become upset if their hands are messy, have a hard time calming down in new settings and isn’t interested in trying new foods.

Here are some tips on how to support an avoider.

General Processing

General Processing items measure the child’s responses related to routines and schedules. This could include daily schedules, routine schedules or task related routines including how children respond to questions, others actions, busy situations, sleeping routines, eating patterns and hygiene needs, daily transitions and other schedule related activities.

These first/then visual boards are a wonderful tool in supporting routines and schedules.

Auditory Sensitivity

This area addresses how children respond to things they hear. Auditory input includes responding to their name,  how easily it is for someone to get their attention and how distracted they become in noisy settings. The brain processes the sounds in our environment and according to this article, sensitivity to sound could be a reaction to a part of our brain that pays more attention to sounds then it needs to. One article explains it this way:

“When there is no medical reason to explain the auditory sensitivity, researchers think that the brain is not processing sounds adequately. Researchers suggest that the part of the brain that receives and filters noise and sound, the amygdala, is working differently.  The amygdala decides on how important noises are.  It decides and which sounds we should attend to and which ones to ignore. When someone experiences sensitivity to sounds, it is thought the amygdala pays more attention to sounds than it needs to.”

Visual Sensitivity

This area addresses how children respond to things they see, including bright objects, such as lights and toys. It describes how they respond to reflections in mirrors and their responses to objects that spin or move suddenly. According to this article our brains interpret the light we see through our eyes, and:

“The visual system uses light to detect information through our eyes and then interprets or makes sense of that information in the brain. It works closely with our vestibular and auditory systems to help us safely navigate our environment by orienting us to where we are in relation to other objects. The ability to cognitively process information we take in through our eyes can be broken down into several categories, called visual perceptual skills. Those with trouble in one area of visual perception may present with strong skills in another area, meaning that deficits in processing of visual information can take on many forms.”

Tactile/Touch Sensitivity

This area addresses how children respond items that touch their skin. This includes bath/water play, getting their nails trimmed and hair brushed, touching different sensory rich objects, being messy and receiving hugs. When children have a tactile sensitivity, their skin reactors are feeling the object more intensely. According to this article:

The tactile system, or sense of touch, refers to the information we receive though the receptors in our skin. It alerts us to pain and temperature and helps us discriminate the properties of things we come in contact with, i.e. texture, shape, size, and weight. From very early on in development this sense plays a crucial role in helping us gain awareness of our own bodies and understand everything we come in contact with. And how frustrating it must be to learn new skills when you can’t adequately feel the objects you’re using!”

Movement Seeker

This area describes how children move within their environment, including if they enjoy movement activities, seem accident prone or clumsy, seek out spinning and/or preferring to walking on their tip toes. Movement is how our bodies know where we are in space and how we respond to a variety of movement activities. This article explains movement seekers as “someone who has a high threshold for vestibular input. The vestibular system is housed in our inner ear, and is responsible for sending messages to our brain about the position and movement of our head. The vestibular system is activated anytime our head is tilted, upside-down, inverted, if we spin, if we run fast or run slow, when we’re on a swing or going down a slide.

We need vestibular activation and an efficient vestibular processing system in order to maintain an upright position, feel balanced, have a full sense of our body in space and focus. Some people have low thresholds, in which they perceive vestibular activation at much higher rates (e.g. hypersensitive to movement). Others have high thresholds, which means that they need more intense, more frequent and longer duration of movement in order to register it and activate their vestibular system.”

Oral

This are addresses how children respond to new foods and different textures, if they tend to overstuff their mouths, how they control chewing/swallowing foods and liquids and if they tolerate their teeth being brushed. Our oral system is based on how our sensory receptors in our mouth recognize what is in our mouth. Some people have increased sensitivities for foods while others have decreased sensitivities to food. There are differences and optional interventions explained in this article:

“We have sensory receptors in our mouths that allow us to recognize information about temperaturetexture (e.g. smooth like yogurt, hard like chips/pretzels, or a mixture of textures like cereal with milk), and taste (e.g. sweet, salty, bitter, sour). They may be over responsive or have increased sensitivity to oral input, causing them to be resistant to oral sensory experiences like trying new foods or brushing their teeth.

Other children may have decreased sensitivity to oral sensory input and therefore seek more oral input in order to help them organize their behavior and pay attention. Our brains receive further proprioceptive input from the joint of the jaw as we bite and chew on foods with different types of resistance (e.g. a crunchy carrot or a chewy sweet/gum).  Oral sensory processing also contributes to the way we move our mouths, control our saliva, and produce sounds for clear speech.”  

Behavioral Differences

This area describes children’s behaviors such as how frequently they have meltdowns, if they are clingy, how hard it is to redirect them, if they are upset in new surrounds and how hard it is to help them calm down.  Teaching children how to calm down using a variety of sensory input, will benefit every child. Soothing Sammy provides opportunity for a child to create their own behavior support tool that is tailored to their specific needs. Weather they respond better to auditory, visual, tactile or others, Sammy the Golden Dog can make redirection to a calm down corner a positive experience for the child and the adult.

Creating a sensory diet is one of the most important ways to support children with any type of sensory difference. These sensory diet cards is a must have resource if you are working with or have a child with a sensory need. 

If you are concerned about your child, you can contact an Early Intervention provider to complete an evaluation from the day they are born all the way until they turn three years old.

Early intervention occupational therapy services support children in all areas of sensory needs, and can help caregivers create sensory diets that will help children in a variety of situations. Visual, tactile, auditory, oral and movement interventions that are supported in a controlled environment, can help every child learn how to adapt and respond to different situations and environments.

Jeana Kinne is a veteran preschool teacher and director. She has over 20 years of experience in the Early Childhood Education field. Her Bachelors Degree is in Child Development and her Masters Degree is in Early Childhood Education. She has spent over 10 years as a coach, working with Parents and Preschool Teachers, and another 10 years working with infants and toddlers with special needs. She is also the author of the “Sammy the Golden Dog” series, teaching children important skills through play.